DES MOINES, Iowa – An Iowa school for juvenile offenders subjects the boys to restraints and seclusion rooms and denies them essential mental health care, a federally funded nonprofit organization alleged Monday in a report that threatened legal action unless the state makes significant changes.

Disability Rights Iowa concluded the Boys State Training School doesn’t have enough mental health professionals, locks up children by themselves and restrains them in beds with full-body wraps. It made the assessment after 11 visits to the facility, interviews with 30 residents and a review of records.

The group said the school’s shortcomings were part of larger problems throughout the state’s system for juvenile offenders.

“This is basically the tip of the iceberg,” said Nathan Kirstein, a staff attorney for the organization. “This is not because this is an evil, deviant place, and if we fix it all our problems will go away. This is symptomatic of all the gaps in services along the way for these youths.”

Congress in the 1970s established the disability rights organizations to help ensure states don’t violate the constitutional rights of disabled residents.

The Iowa organization made numerous recommendations for changes in its report and threatened to file a federal lawsuit against Gov. Kim Reynolds, the Department of Human Services administrator and other officials if changes aren’t implemented. After the organization made similar claims in 2013 against the State Training School for Girls in Toledo, then-Gov. Terry Branstad ordered the institution closed.

School Superintendent Mark Day said he agreed with the report’s call for expanded mental health services but argued that funding limits and a statewide shortage of psychologists and psychiatrists made it difficult to provide more treatment.

“I don’t know of anybody in this field who wouldn’t love to have more psychiatric, psychological, therapeutic services,” Day said. “… There’s an increasing shortage of those folks that are willing to work in a correctional, juvenile mental health facility.”

The State Training School has space for 130 boys aged 12 to 18 and currently has about 100 students, all assigned to the institution by court order for crimes ranging from drug offenses to violent offenses such as murder and assault. The school, which dates to 1873, is in Eldora, a city of 2,700 people about 60 miles north of Des Moines.

Although about 60 percent of the boys at the school take psychotropic drugs, Disability Rights Iowa’s report notes the institution’s sole psychologist isn’t state-certified and that a psychiatrist works part-time on a contract basis.

The report states that from Nov. 1, 2016, to April 30, 2017, nearly three-fourths of residents were put in seclusion rooms, with more than half of the stays for more than an hour and 6 percent for more than 24 hours. The group claims that sometimes, students are put in seclusion room as punishment, including for trivial infractions.

It also questioned the use of a restraint called a “wrap,” in which boys are held by straps around their wrists and ankles with a cloth around their body attached with Velcro.

Day responded that restraints and seclusion are used as little as possible and only to protect boys from abusing themselves.

Disability Rights Iowa called for transferring all students with mental illness or intellectual disabilities to facilities where they can receive proper treatment.

“If there was a kid in a facility like this who had cancer or diabetes, we would certainly hold the state accountable for providing them that care, and it doesn’t matter if your illness happens to be schizophrenia or attention deficit disorder,” said Emily Ehlers, a Disability Rights Iowa attorney.

State officials noted the state is working with an outside expert to make improvement but said the institution was already succeeding.

“We educate kids that no one else in this state has been successful educating,” Day said. “More importantly, we keep kids safe that no else in the state has been able to keep safe.”